HomeMy WebLinkAbout05-5240
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
MOBILE HOME SET-UP
,/
5240
Permit Number: 5240
Permit Type: MOBILE HOME
Class of Work: MOBILE HOME SET-UP
Proposed Use: MOBILE HOME SUBDIVISION
Square Feet:
Est. Value:
Improv. Cost:
Date Issued: 12/13/2005
Total Fees: 4,442.58
Amount Paid: 4,442.58
Date Paid: 12/13/2005
Work Desc: MOBILE HOME SETUP
Address: 37533 LILLY BEA LOT 250
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: GRAND HORIZONS
Parcel Number:
Name: GRAND HORIZON
Address: 37533 LILLY BEA LOT 250
ZEPHYRHILLS, FL. 33542
Phone:
ACE AIR CONDITIONING & ELEC.
MOBILE HOME SET-UP
MOBILE HOME MECHANICAL
MOBILE HOME TIFISUB 99%
PARK FEES MH
FIRE IMPACT FEE
IRRIGATION METER
PUBLIC SAFETY 5%
60.00 WATER CONNECTION MOBILE HC
35.00 MOBILE HOME PLUMBING
1,572.12 MOBILE HOME TIFISUB 1%
573.73 POLICE IMPACT FEE
273.00 WATER METER RES 3/4"
180.00 IRRIGATION CONNECTION
26.35
209.50
40.00
15.88
254.00
180.00
175.00
6 (l~ ov/
I I; Il9Y
FINAL
REINSPEC110N FEES: When extra inspection trips are necessary due to anyone of the following reasons, a
charge of Thirty-five dollars ($35.00) shall be made for each trip for each trade:
(a) Wrong address (b) Condemned work resulting from faulty construction (c) Repairs or corrections not made when
inspection called (d) Work not ready for inspection when called
(e) Permit not posted on job site (f) Plans not at job site (g) Work not accessible
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
Complete Plans, Specifications and Fee Must Accompany Application.
All work shall be performed in accordance with City Codes and Ordinances
NO OCCUPANCY BEFORE C.O.
~ rJZ~ ~
. CONT~C :SS;GNA+URE ~MITOFFI
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
CITY OF ZEPHYRHILLS PERMIT APPLICATION
BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
813-780-0020 FAX: 813-780-0021
PHONE GONTACT FOR
DATE RECEIVED id-J\~ Ics
PERMITTING'?/3 7~ 3-)'{ILfO
fig.. 91], ')'25:6
OWNER'S NAME GI(ar)~2(J(>S
JOB ADDRESS?; 75"33 L ,')1 ~ e etA.
LEGAL DESCRIPTION: LOT(S)
PHONE
Lof 250
BLOCK
SUBDIVISION
\\IORK PROPSED: 0 NEW CONSTRUCTION
o ADDITION
(OBTAIN FROM PROPERTY.TAX NOTICE)
OALTERATION 0 REPAIR ~STALL
PARCEL 10 #
o SIGN
o MOVE
o DEMOLISH
PROPOSED USE: OSGL FAMILY DWELLING
o COMMERCIAL
OMULTI - FAMILY
o INDUSTRIAL
0# OF UNITS
o SWIMMING POOL
~OBILE HOME
o OTHER
BUILDING SIZE
c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
Wo.RK. 5e+-itp vn6bjle. h()~
g/ xLI ~SQUARE FOOTAGE /'-132
HEIGHT
DESCRIPTION OF
RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.
IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
PROPERTY SURVEY REQUIRED FoR ALL NEW CONSTRUCTION.
PERMITS REQUESTED
o BUILDING
$
VALUATION OF TOTAL CONSTRUCTION
o ELECTRICAL
AMP SERVICE
o Progress Energy 0
W,R.E.C.
o PLUMBING
o MECHANICAL
$
VALUATION OF MECHANCIAL INSTALLATION
o GAS
o ROOFING
o SPECIALTY
o OTHER
TYPE OF CONSTRUCTION: 0 BLOCK
o FRAME
o STEEL
o OTHER
FINISHED FLOOR ELEVATIONS
IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
BUILDER
SIGNATURE~...-,.- {}~~
COMPANY
STATE CERT OR REGIST #
EJ;..ECTRICIAN
SIGNATURE ~~ ~~
******************************************************************
COMPANY Ac e
STATE CERT OR REGIST #
******************************************************************
PLUMBER
SIGNATURE h,.....,. /'" ~
COMPANY r3u.-f-f~ e.1d
STATE CERT OR REGIST #
MECHANICAL
*******************************************~**********************
COMPANY /1 L ~
SIGNATURE~......... 61..... ~ ./~
/
STATE CERT OR REGIST #
********************************************************k********
OTHER
COMPANY
SIGNATURE
STATE CERT OR REGIST #
A. NOTI~E OF DEED RESTRICTIONS
Tha undersigned understands that this permit may be subject to "deed restrictions" which
may be more restrictive than City regulations. The undersigned assumes responsibility for
compliance with any applicable deed restrictions.
B. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES
If the owner has hired a contractor or contractors to undertake work, they may be required
to be licensed in accordance with state and local regulations. If the contractor is not
licensed as required by law, both the owner and contractor may be cited for a misdemeanor
violation under state 'law. If the owner or intended contractor are uncertain as to what
licensing requirements may apply for the intended work, they are advised to contact the
City of ZephyrhillS Building Department, 813-780-0020.
Furthermore, if the owner has hired a contractor or contractors, he is advised to have the
contractor(s~ sign po~tions of the "Cohtractor Sections" of this ~pplication for which they
will be responsible, If you, as the owner signs as the contractor, you are indicating that
you, rather than the contractor, are responsible for the work, If the contractor wishes
you to sign as contractor that may be an indica~ion that he is not properly licensed and is
not entitled to permitting privileges in the City of Zephyrhills.
C. TRANSPORTATION IMPACT FEES AND UTILITY CONNECTION FEES
D. CONSTRUCTUION LIEN LAW (CHAPTER 713, FLORIDA STATUTES, AS AMENDED)
I certify that I; the applicant, have been provided with a copy of "Florida's Construction
lien Law _ Homeowner's.protection Guide" prepared by the Florida Department of Agriculture
and Consumer Affairs. If the applicant is someone other that the "owner", I cerify that I
have obtained a copy of the above described document and promise in good faith to deliver
it to the "owner" prior to commencement.
E. CONTRACTOR'S/OWNER'S AFFIDAVIT
I certify that all the information in this application is accurate and that all work will
be done in compli~nce with all applicable laws regulating construction, zoning, and land
development.
Appli~ation is hereby made to obtain a.peFmit to do work and installation as' indicated. I
certify that no work or installation has commenced prior to issuahce of a permit and that
all work will be performed to meet standards of all laws regulating construction, City
codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other governmental agencies may apply to
the intended work, and that it is my responsibility to identify what actions I must take to
be in compliance. Such agencies include but are not limited to: *Department of
Environmental Regulation-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment
*Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas,
Altering Watercourses
*Army Corps of Engineers-Seawalls, Docks, Navigable Waterways
*Department of Health & Rehabilitative Services, Environmental Health Unit-Welfs,
Wastewater Treatment, Septic Tanks
*U.S. Environmental Protection Agency-Asbestos abatement
I also certify that, if fill material is to be used in Flood Zone "A" or "A, etc.", it is
understood that a drainage plan addressing a "compensating volume" will be submitted which
is prepared by a professional en~ineer registered in the State of Florida prior to permit
issuance.
A permit issued shall be construed to be a license to proceed with the work and not as
authority to violate, cancel, alter, or set aside any provisions of the technical codes,
nor shall issuance of a permit prevent the Building Official from thereafter requiring a
correction of errors in plans, construction, or violations of any code. Every permit
issued shall become invalid unless the work authorized by such permit is commenced within
six months of issuance, or if work authorized by the permit is suspended or abandoned for'a
period of six months after the time the work is commenced. One 90 day extension of time
may be allowed for the permit with fee charge of $15.00. The extension shall be requested
in writing to'the Building Official. An approved inspection must be logged during each six
month period, or the project will be considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD ~ NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. JOB"S UNDER
$2,500 IN VALUE DO NOT NEED TO RECORD AND POST A "NOTICE OF COMMENCEMENT".
SIGNATURE: CONTRACTOR
SIGNATURE: OWNER OR AGENT
acknowledged
,20_
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was
Before me this _____day of
by
STATE OF FLORIDA
COUNTY OF
;he foregoing instrument was
Before me this _____ day of
by
acknowledged
,20_
(name of person acknowledged)
Owho is personally known to me, or
(name of person acknowledged)
[1ho is personally known to me, or
of identification)
take an oath.
Owho has produced
(type of identification
and who 0 did Qiid not take an oath
Signature of person taking acknowledgment
Signature of person taking acknowledgement
Name typed, printed or stamped
Name typed, printed or stamped
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PERFORMANct;: BUSINESS PRODUCTS. INC, 813-71a.B008 FAX 813-719-7918
CITY OF ZEPHYRHILLS
ZEPHYRHILLS, FLORIDA
s- 0 1 q;;
.
WATER ACCT. NO.
DATE
\2.-/r3/o~
OWNER/ (2
RENTER l-:JLI.. ~("" ~ -'2.\d. ":::>
- ("-or ~ ~'<\ '2..O"'h
MAILING
SERVICE ADDRESS 37 "S ~ ~
L:\\"-"'I ~~
,
Lo r-Z50
SHUT OFF SERVICE
o
13"
~
o WATER
.: ~- -~ ~
TURN ON SERVICE
o SEWER
INSTALL METER
o GARBAGE
READ METER
o
~CITY
CHECK METER
o
o OUT CITY
OTHER
o
~ No. OF UNIlS
_ DEPOSIT AMOUNT
_ AMOUNT LAST BILL
:r '("'C\ ,?:>a.-~ LIY"\ ~
_ DATE
_ MISC. CHARGE
WORK COMPLETED BY
& DATE COMPLETED
ORDER TAKEN BY
~
Retain white form in office at all times.
Send pink & yellow forms to Water Service Dept.
Water Service Dept. to sign yellow form & return to office.
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PERFORMANCI;: BUSINESS PRODUCTS, INC. 813-718-8008 FAX 813-7111-70111
5- r; 3Cf (
CITY OF ZEPHYRHILLS
ZEPHYRHILLS, FLORIDA
WATER ACCT. NO.
DATE \ 2-11~ f OS'"
.
OWNER/
RENTER
Gt"~ W-cr\'Z.CfY)"5, - l3u..J..\E.,c..9\.Q.(d. ~
MAILING
3"7 ~~3 7 ~ \ \'-.J ~o 0-
~
\.....c:.\- .250
SERVICE ADDRESS
3/53~
L~ \, '-t ~ 0..-
,
l,-o'r- 2 '5 ~
13" WATER
SHUT OFF SERVICE
D
,u;r
~
D SEWER
...\,_.<' ~
TURN ON SERVICE
READ METER
D
D GARBAGE
gl'IN CITY
INSTALl METER
CHECK METER
D
D OUT CITY
-L No. OF UNITS
OTHER
D
_ DEPOSIT AMOUNT
_ AMOUNT LAST BILL
31L.\;rt W~~
_ DATE
_ MISC, CHARGE
WORK COMPLETED BY
& DATE COMPLETED
ORDER TAKEN BY
Retain white form in office at all times.
Send pink & yellow forms to Water Service Dept.
Water Service Dept. to sign yellow form & return to office.
PASCO COUNTY, FLORIDA
Permit No.
Date Permitted
50lY:O
12/13/os
Builder Name/Owner Name Go(' ana.. ..\-\oc-r2..C/"'r",
Control #
County Parcel No. 34 - do S -~ \ _ 01'0 - 00000,- asco SubDiv:
Address/Location 3/5""3'3 1-.\ \ \ ~ ~a.....
Classification/Type of Use YY'l0b,\VL ~
\.-..0 + 2. C5 0
TRANSPORTATION IMPACT FEE
Rate:
Sq Ft Unit:
Exempt 0 Yes [2f No
How Determined
Impact Fee Amount $ \ t:5 <\?~ . 0 0
Zone No.
TAZ:
SCHOOL IMPACT FEE
Account (056) Single-Family Detached House
(057) Mobile Home
(058) Other Residential
JJ 23) Collection Fee
Exempt ~ Yes D No How Determined
Amount $
PARKS AND REC~ION FEE
Land Account "..........., Land Credit
'-
-.........-................
Land Total
Recreation Account
Recreation Total
Zone
$
Exempt 0 Yes D No
LIBRARY FEE
Land Account
How Determined
Land Credit
Land Total
Facility Account
Facility Total
Exempt 0 Yes D No
RESOURCE FEE
TOTAL AMOUNT
How Determined
Total Amount
ERU
Prepared By
Checked By
NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION
PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE
BEEN PAID AND
RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY
Acknowledgement below does not imply acceptance of concurrence, but simply receipt of a copy of this form, placing
the building permit owner on notice of this assessment and the conditions of payment for same.
DATE
RECEIPT NO.
RECEIVED BY
DATE
BY
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